Recovery of Aerobic and Anaerobic Bacteria in Sinus Fungal Ball

This case study with chart review describes the aerobic and anaerobic microbiology of specimens obtained from 47 patients with Aspergillus spp fungus ball. Bacteria were recovered from 32 of the 47 (68%) patients. Eighty-six isolates, 29 aerobic and facultatives and 57 anaerobic, were recovered. Aerobic and facultatives only were recovered in 6 instances (19% of culture-positive specimens), anaerobes only in 11 (34%), and mixed aerobes and anaerobes in 15 (47%). The predominant aerobes were Staphylococcus aureus (6 isolates), α-hemolytic streptococci (5 isolates), Enterobacteriacae (4 isolates), and microaerophilic streptococci (4 isolates). The predominant anaerobes were Gram-negative bacilli (26), Peptostreptococcus spp (14), and Fusobacterium spp. (10). Twenty-two β-lactamase–producing bacteria were recovered from 15 patients. These included all 6 S aureus and 2 Bacteroides fragilis group isolates, 4 of 10 of Fusobacteria, and 7 of 19 Prevotella and Porphyromonas. This study demonstrates the recovery of polymicrobial aerobic-anaerobic flora in the sinuses of patients with fungus ball.